Transcript Mechanisms of Traumax

Mechanisms &
Characteristics of Sports
Trauma
Tissue Stresses Leading to Injury
Tension~ pulls or stretches tissue
Stretching~ pulls beyond elastic limit
Compression~ force that crushes tissue
Shearing~ force that moves across the
parallel organization of the tissue
Bending~ force on a horizontal bone
that places stress within the structure
causing the bone to bend or strain
Soft-Tissue Injuries
Blister~ Continuous friction causing a
collection of fluid within the epidermal
or dermal layers
Abrasion~ scrape or strawberry
Laceration~ tear of epidermis with
rough edges
Incision~ tear of epidermis with smooth
edges
Soft-Tissue Injuries
Contusion~ bruise
Avulsion~ tear that results in the
involved tissue being completely ripped
from its source
Puncture~ a foreign object penetrates
the skin
Skeletal Muscle Injuries
Contusion
Deeper contusion = more severe
Extra blood forms a membrane encapsulated
blood tumor
Strain
Stretch, tear, or rip in muscle, fascia, or tendon
MOI
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Forceful muscle contraction
Nuero-inefficiency of agonist/antagonist contractions
Strength imbalance b/w agonist/antagonist muscles
Fatigue producing metabolites in the muscle
Skeletal Muscle Injuries
Cramps
Painful involuntary contraction
Usually due to dehydration and electrolyte loss
Spasm
Reflex contraction caused by trauma to upper
motor neuron or musculoskeletal system
Guarding
Protective mechanism that causes an involuntary
contraction following injury
Skeletal Muscle Injuries
Muscle Soreness
Acute-onset
• Accompanies fatigue and occurs during and immediately
after exercise
Delayed-onset
• Onset is 12 hours post-exercise
• Most intense 24-48 hours post-exercise
• Relief within 3-4 days
Muscle Stiffness
Occurs when a group of muscles have been overexerted for a prolonged period
Chronic Skeletal Muscle Injuries
Myositis~ inflammation of muscle tissue
Fasciitis~ inflammation of tissue
separating muscle
Tendinitis~ inflammation of tendon
Tenosynovitis~ inflammation of synovial
sheath surrounding tendon
Atrophy~ muscle wasting
Contracture~ shortened muscle
Synovial Joints
Ball and Socket
Shoulder and hip
Allows all motion
Gliding
Nonaxial joint
Carpal/tarsals
Synovial Joints
Hinge
Uniaxial joint
Knee/elbow
Flexion/extension
Saddle
Biaxial joint
Allows two motions
• Flexion/extension, ab/adduction, circumducion
Synovial Joint Phsyiology
Joint Capsule
Cuff of fibrous tissue that functions to
maintain a relative joint position
Ligaments
Fibrous tissue that functions to connect
bone to bone
Strongest in the middle
Synovial Joint Physiology
Synovial membrane
Lines the joint capsule and secretes/absorbs
synovial fluid
Synovial fluid
Joint lubricant
Changes viscosity with the speed of movement
Articular cartilage
Hyaline: nasal septem, larynx, trachea, bone ends
Fibrous: vertebral discs, symphysic pubis, menisci
Elastic: external ear, Eustachian tube
Synovial Joint Phsyiology
Nerve Supply
Mechanorecptors provide info about the
joint position
• Located in capsule and ligaments
• Myelinated fibers, unlike pain receptors
Anatomical formation
• More movement = less joint stability
– Must rely on muscles and ligaments for support
• Less movement = more joint stability
Synovial Joint Injuries
Sprain
MOI = traumatic joint twist that results in
ligamentous/capsule tearing
• Grade 1 = pain, no instability, little swelling
• Grade 2 = pain, moderate instability, swelling
• Grade 3 = pain, instability, possible subluxation, gross
swelling
Acute synovitis
Injured synovial membrane in conjunction with
sprain
Synovial Joint Injuries
Subluxation
Partial separation between two articulating
bones
Dislocation
Complete disunion between two
articulating bones
Synovial Chronic Joint Injuries
Osteochodrosis
Degenerative changes in the ossification centers
of the bone ends (epiphysis)
• Common in children during growth spurts
Osteochondritis dissecans is a type of
osteopchodrosis
Apophysitis is a type of osteochodrosis
Causes:
• Avascular necrosis
• Trauma causing articular cartilage fx
Synovial Chronic Joint Injuries
Traumatic arthritis
Trauma to articular surfaces and structures causes
thickening of bone and synovium
• Pain, muscle spasm, and crepitus
• Weakened ligaments and loose bodies are possible
Bursitis
Inflamed bursa due to constant pressure or
trauma from overused muscles and/or tendons
May lead to a calcific bursa
Synovial Chronic Joint Injuries
Capsulitis
Inflammation of capsule following repeated
microtrauma
Associated with synovitis
Synovitis
Joint congestion with edema
Synovial membrane becomes thickened and
degenerative
Restricts movements
Bone Fractures
Open vs. Closed
Depressed
Mostly in flat bones (i.e. skull)
Indented fx caused by falling or striking an object
Greenstick
Mostly in adolescent bones
Incomplete fracture
Impacted fx
Bone is impacted causing a shortening of bone
Depressed Fx
Greenstick Fx
Impacted Fx
Bone Fractures
Longitudinal
Bone splits along its length
Caused by jumping from a height or landing so to
stress the longitude of the long bone
Oblique
Fx line is diagonal to bone length
Created by a torsion force at one end with the
other end fixed
Serrated
Two fx ends are sharp and jagged
Caused by a direct blow
Oblique Fx
Bone Fractures
Spiral
S-shaped fx site
Created by a torsion force at one end with the
other end fixed
Transverse
Fx line is at a right angle to length of bone
Caused by a direct blow
Comminuted
Fx site has 3 or more bone fragments
Caused by a direct blow or fall in an awkward
position
Bone Fractures
Countrecoup
Fx site on opposite side of impact
Blowout
Inferior orbital wall is fractured trapping inferior
eye muscle
• Unable to look up
Avulsion
Separation of bone fragment from its cortex at the
attachment site of ligament or tendon
Caused by sudden twist or torsion
Blowout Fx
Bone Fractures
Stress
MOI
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Continuous muscle contraction
Altered stress distribution from fatigue
Change in group reaction forces
Rhythmic repetitive stress leading to a vibratory
summation point
• Postural conditions
– Flat feet, pronated feet, leg length discrepancy
Bone scan can provide an early dx
Nerve Injuries
Nerve injuries typically result from
compression or tension forces
Compression = nerve pinch causing muscle
weakness and sharp, burning, radiating
pain down muscle
Tension = nerve stretch causing muscle
weakness and sharp, burning, radiating
pain down muscle