Transcript File - Huff Hills Ski Patrol

Chapter 20, Section 1
Musculoskeletal Injuries
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Objectives
20.1.1 Describe the functions of the following
structures:
a.
b.
c.
d.
e.
f.
bones
cartilage
joints
muscles
synovium
tendons
20.1.2 Describe the physiology of human
movement.
BRADY
continued
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Objectives
20.1.3 Describe how musculoskeletal tissues
heal.
20.1.4 List the six types of musculoskeletal
injuries.
20.1.5 Compare and contrast sprain and
strain.
20.1.6 Describe two classifications of
fractures.
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Objectives
20.1.7 List the signs and symptoms of
sprains and fractures.
20.1.8 Define the following terms:
a. dislocation
b. fracture
c. sprains
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Topics
 Anatomy
and Physiology
 Physiology of Human Movement
 Common Musculoskeletal Injuries
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Case Presentation
A male teenager is found on
the snow below a jump. He is
wearing twin tipped skis and
a helmet.
He complains that his right
thigh hurts “very bad”, and
you notice that his right
forearm is also angulated.
His buddies report that he
landed “hard.”
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Anatomy and Physiology
– the skeleton
 Joints – the motion
 Muscles – the power
 Bones
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Skeleton
 Provides
structure and protection
 Axial skeleton – skull, vertebrae, and
thoracic cage
◦ Transfer weight from upper to lower
body
◦ Responsible for upright position
skeleton – shoulder,
arm, pelvis, legs
 Appendicular
◦ Responsible for movement
BRADY
continued
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Skeleton
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Skeleton
 Types
of Bones
◦ Long: Humerus, radius, ulna, femur,
tibia, fibula
• Breaks at epiphyseal line (growth plate) can
be serious for growing children
◦ Flat: Skull, scapula, ribs, sternum, pelvis
◦ Irregular: Vertebrae, wrist, hands, ankle,
feet, patella
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Skeleton
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Joints
 Joint:
Two bones and the connective
tissues that surround, support, and
stabilize it called the joint capsule.
Synovial fluid in the joint capsule
lubricates joints.
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Joints
 Range/type
of motion depends on
type of joint:
◦
◦
◦
◦
◦
BRADY
Ball and socket
Hinge
Gliding
Pivot
Suture
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Joints
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Ligaments and Tendons
 Ligaments
connect bone to bone,
form part of joint capsule
◦ Restrict the motion of the joint
◦ Tightness/laxity help determine extent of
movement
 Tendons
connect muscle to bone
 Both can be stretched or torn
◦ Stability and function suffer
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Ligaments and Tendons
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Muscles
contracts and relaxes – often
work in pairs
 Controlled by nervous system – spinal
and peripheral
 Three types:
 Tissue
◦ Skeletal (voluntary)
◦ Smooth
◦ Cardiac
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Muscles
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Physiology of Movement
 Skeletal
muscle message is
“contract”
◦ Signal provided by nerves
◦ May be voluntary or involuntary
◦ Pairs work in coordination to flex and
extend joints
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Healing Process
 Factors
are extent of damage, age,
nutrition, overall health
 Bone healing requires nutrients,
oxygen, and immobilization
 Muscles and ligaments heal slowly
 Tendons need protection during
healing
 Cartilage does not heal, it is often
removed
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
The Healing Process
Copyright Nancy Pitstick
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Common
Musculoskeletal Injuries
 Sprain
◦ Stretching or tearing of a ligament
• Tears may need surgery
◦ Joint is displaced beyond its normal
alignment
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Common
Musculoskeletal Injuries
 Strain
◦ Stretched or torn muscle
• Overexertion or poor body mechanics
• May range from minor to severe
◦ Strain versus Sprain
• You strain a muscle or tendon and sprain a
ligament.
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Common
Musculoskeletal Injuries
 Tendon
rupture
◦ Active motion of joint may be lost
 Fracture
◦
◦
◦
◦
BRADY
Break in a bone
May be open or closed
May be displaced or non-displaced
May be associated with internal or
external bleeding
continued
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Common
Musculoskeletal Injuries
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Common
Musculoskeletal Injuries
 Dislocation
◦ Separation or displacement of bones at
a joint
◦ Usually the result of forceful trauma
 Multiple
structures and surrounding
tissues may be injured in a single
event
◦ Soft tissues, nerves, and blood vessels
may be involved
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Fractures
 Butterfly
 Comminuted
 Compression
 Epiphyseal
 Greenstick
 Impacted
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Fractures
 Oblique
 Pathologic
 Spiral
 Transverse
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Fractures
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Possible Blood Loss from
Fractures
 Pelvis
(1300-1500 ml)
 Femur (500-1000ml)
 Humerus (300-500ml)
 Tibia/Fibula (150-250ml)
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Case Update
You perform a primary assessment. The patient
states that he caught “way too much air and
crashed.” The patient’s respiratory rate is 16 and his
left radial pulse is 100 and strong, but the radial
pulse in his injured right arm is absent.
You immediately call for assistance, a long spine
board, a splint for the femur and transportation to the
first aid room. Because of the mechanism of injury,
the lack of a right radial pulse, and the fact that
ground transport to definitive care will take over 2
hours, you radio for air transport.
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River, NJ