Transcript Chapter 4- Wound Care

Lesson 5
Taken from Chapters 4, 8 and 13 in your
Book
Lesson 5
Terminology and Tissue Anatomy
 Anatomical Position
 3 Planes – Multiplanal
______________________ – Right/Left
Transverse or horizontal – Top/Bottom
______________________ – Front/Back
 Directional Terms – how one body part is in
relation to another web page
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Direction Terms
 Medial - Toward the midline of the body
 Lateral - Away from the midline of the body
 Proximal - Toward a reference point (extremity)
 Distal - Away from a reference point (extremity)
 Inferior - Lower or below
 Superior - Upper or above
 Anterior - Toward the front
 Posterior - Toward the back
 Dorsal Posterior
 Ventral Anterior
Terms in Use
 The neck is __ to the head
 The thumb is ___ to the middle finger
 The knuckles are ___ to the elbow
 The outer ear is ___ to the ear drum
 The eyes are on the ___ the head
 The ankle is on the ___ part of the body
Terms In Use Cont
 The patella is _________ to the ACL
 The shoulder blade is on the ________ and
_________ aspects of the body
 The heart is ________ to the chest muscles
 The triceps are on the _________ aspect of
the body.
Range of Motions (ROM)
Click here for details
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Flexion/Extension
Dorsiflexion/Plantar Flexion
Abduction/Adduction
Circumduction
Rotation – Internal/Medial and External/Lateral
Supination/Pronation
Inversion/Eversion
Protraction/Retraction
Elevation/Depression
Opposition
Skin Anatomy
 First layer of defense against injury; most frequently
injured body tissue
 Needed to protect against bleeding and infection
 Two major region
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Epidermis-superficial layer- ____________________
_____________________________________
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Dermis-Deep layer- contains hair follicles, blood
vessels, nerve endings
 Resist ____________________________________
Soft Tissue Injuries
Fig 8-5 p.236
 Abrasion = scrape (shear force) (___)
 Blisters = repeated shear force (_____)
 Skin bruises (contusions) = Compression force
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(____)
Incision = clean cut (_____)
Laceration = jagged cut (_____)
Avulsion = loss of tissue (_____)
Puncture = sharp object penetrates skin (_____)
Muscles and Tendons
 Muscle Fibers are surrounded by
______________ (Inner) Small amount of
fibers make up fascicles surrounded by
__________ (Middle)
 A muscle is made up of a number of fascicles
which are surround by ___________ (Outer)
 Muscle Sheath/Fascia
Muscles and Tendons
 Purpose- movement, maintaining posture,
stabilizing joints, and generating heat as they
contract
 Extensibility = Ability to stretch/increase in
length
 Elasticity = Ability to return to normal length
after lengthening/ shortening
Tendons
 Tendons- assist in movement of body part
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_____________________________
Collagen or tissue is in parallel pattern
High resistance to unidirectional forces
____________________________
Muscle contractions – p85-87
 Concentric Contraction
= muscle shortening against resistance
 Eccentric contraction
= muscle lengthening against resistance
 Isometric contraction = _______________
_________________
 Isotonic contraction = _________________
__________________
 Isokentic =________________________
Muscle stretching – p68-73
 Figure out muscle and its action(s)
 Stretch in __________________
 _____________________
 _____________________
 Three kinds of stretching
 Ballistic (bouncing) Want to avoid this type
 Dynamic – moving while stretching T&F, BSB
 Static –Hold in a position for at least 20 secs
 PNF Stretch, Contract, Stretch
Soft tissue injury classifications
p.324-329
 Contusions
 Severity depends on depth and tissue affected
 1st degree = little or no ROM restriction; slight
discoloration, pain w/ movement, pt tender
 2nd degree = moderate ROM restriction; S/S increase
 3rd degree = severe ROM restriction; S/S increase
 Muscle cramps/spasm
 Myositis/ fasciitis
Soft tissue injury
classifications cont
 Strain = injury to muscle or tendon
 Tendonitis (tendon)
 Tenosynovitis (synovial sheath over tendon)
 Myositis ossificans (muscle to bone)
 Bursitis (bursae)
Categories of Strains – p.324-325
 1st degree: some pain, microtears of collagen, mild
symptoms: pn, point tenderness, swelling, ROM
decreased
 2nd degree: More tissue destruction, moderate
symptoms, joint laxity/instability, muscle weakness,
increased ROM loss, ecchymosis (tissue
discoloration).
 3rd degree: Severe tissue destruction, severe
symptoms, complete instability, loss of ROM,
palpable defect (early), ecchymosis
Joints – p.322-323
 Meeting of two bones
 Various types of joints –fibrous, cartilaginous, and
SYNOVIAL
 Synovial- most common; freely moveable; all joints
of the limbs fall into this class
 Features of a synovial joint –Fig 13.5
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Articular Cartilage-protects the ends of your bones
Joint Cavity- Space between bones which is filled w/
synovial fluid
Articular Capsule-Surrounds the joint cavity
Synovial Fluid-Lubricates the joint and articular
cartilage
Reinforcing Ligaments-ACL, PCL, LCL, MCL
Joint Injuries
 _____________ = injury to ligament; mechanism of injury-
twisting, direct contact, dynamic overload, 3 degrees
 _____________-Partial displacement of the joint surface;
structure damage does occur; check a distal pulse
 _____________-displacement of joint; major structure damage,
instable joint, severe pain, loss of ROM; check distal pulse
Treatment To Closed Tissue
Injuries
 Apply Ice with a compression wrap immediately for
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at least 20 minutes; check for a distal pulse
If no fracture suspected elevate body part
Repeat the process every 1-2 hours
NSAIDS if able
Supply Crutches if necessary
Continue Ice Application up to 72 hours
Keep body part wrap with compression
Refer to physician if necessary
Bones – p317-321
 Purpose-support, protection, reservoir for minerals
for the bulk of blood cells, aid in movement w/
muscles
 Bone Classification:
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_______-consist of a shaft and 2 ends; all bones of
limbs fall into this category
_______-cubelike; bones of wrist and ankle
_______-flat, thin and usually a bit curved; ribs and
sternum
_______-don’t fit into any of the above categories;
vertebrae and hip bones
Bone Anatomy – Fig 13-1
 Structure of Bones:
 Diaphysis-shaft of bone
 Epiphyses-__________________________
____________________________________________
____________________________________________
__________________________________________
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Membranes
 periosteum- __________________________
_______________________
Endosteum- inner layer of bone
Inside bone- contains bone marrow
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Bone injuries
 Fracture = Disruption in continuity of a bone =
break
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Simple = skin remains intact
Compound = skin integrity compromised
See types of fractures – Fig 13-3
 Stress fractures (repeated low-magnitude
forces)
 Treatment – See lesson 4