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Chapter 9
Injuries to the Tissues
Types of Injuries
•Cuts
•Abrasions
•Contusions
•Muscle strains
•Ligament strains
•Inflammation of the
tendons
•Joint dislocations
•Fractures
•Injuries to specific
organs
•Overuse injuries of
the limbs and joints
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Cell
• Basic structural and functional unit of all living
organisms
• Smallest structure capable of performing all
activities vital to life
• Cells and the tissues they form allow the body
to perform the functions that are vital to life.
• Breathing, eliminating waste products, and
maintaining homeostasis
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Tissues
• Composed of similar cells that are specialized to perform a
particular function
• Four main categories
•
•
•
•
Epithelial
Connective
Nerve
Muscle
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Controlling Bleeding
• All bleeding must be controlled.
• Always wear gloves when dealing with blood or other body fluids.
• Profuse bleeding (hemorrhage) is a serious, life-threatening
condition.
•
Can lead to shock and death
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Controlling Bleeding
• Bleeding can be internal or external.
•
•
Internal is often result of blunt trauma or a medical condition
External can occur from capillaries, veins, or arteries
•
•
Capillary bleeding is the most common type and occurs with most injuries
Applying a sterile pad and compression will usually control bleeding in
minor cuts.
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Controlling Bleeding
• Venous bleeding
– Controlled by placing a sterile compress over the
wound
– A gloved hand applies direct pressure to the site.
– Normal blood takes 4-6 minutes to clot; pressure
should last at least 6 minutes.
– Blood may take longer to clot due to some conditions
(e.g., a patient on blood thinners).
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Controlling Bleeding
• Arterial bleeding
– Caused by a punctured or severed artery
– Arterial blood is bright red and pulsates
(spurts) because it is under pressure.
– Must be controlled immediately to prevent
shock
– Direct pressure is the best method for
controlling arterial bleeding.
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Controlling Bleeding
• Arterial bleeding
– Elevating the injured part can also help;
however, do not move the extremity when
there is a fracture or spinal cord injury.
– If indirect pressure with elevation is not
successful, use indirect pressure.
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Controlling Bleeding
•Pressure Points
•
•
•
•
•
•
Temporal artery
Carotid artery
Subclavian artery
Brachial artery
Ulnar artery
Iliac artery
• Femoral artery
• Popliteal artery
• Dorsalis pedis artery
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General
Principles of Wound Care
• Always wear gloves when handling wounds.
• Control any bleeding.
• Cleanse the wound.
• Immobilize the injured part.
• Apply ice (except for snakebite).
• Handle the wound gently.
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General
Principles of Wound Care
• Have a physician rule out infections.
•
MRSA
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Guidelines for
Applying Bandages
• Always remove rings, watches, or bracelets from the patient if
dressing a hand or wrist.
• Try to leave fingers and toes exposed to check on circulation and
sensation.
• Use sterile material.
• Control any bleeding.
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Guidelines for
Applying Bandages
• Open the dressing package using sterile technique.
•
Touch only the corners.
• Cover the entire wound.
• Apply bandage snugly but not too tightly
•
Check for circulation.
• Secure all loose ends with tape.
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Guidelines for
Applying Bandages
• Put the bandage on in the position in which it is to remain.
• Ask the patient how the dressing feels.
If it is uncomfortable,
rearrange it.
• Stay within OSHA guidelines.
• Provide the patient with instructions for wound care.
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Superficial
Injuries to Soft Tissues
• Involve damage to one or more of the tissues surrounding the bones
and joints
• Can involve the skin, fascia, cartilage, muscles, tendons, ligaments,
veins, or arteries
• Wounds are open or closed.
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Superficial
Injuries to Soft Tissues
•Abrasions
•Lacerations
•Avulsions
•Puncture Wounds
•Incisions
•Avulsions
•Calluses
•Blisters
•Bites and Stings
•Hematomas
•Contusions
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The Muscular System
• Composed of over 600 muscles
• Muscles are made up of bundles of tiny contractile muscle fibers.
•
Held together by connective tissue
• Fibers initiate movement when they are stimulated by nerve
endings.
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Types of Movement
•Rotation
•Adduction
•Abduction
•Extension
•Plantar flexion
•Palmar flexion
•Dorsiflexion
•Eversion
•Inversion
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Types of Muscle Tissue
• Cardiac muscle
–
Makes up the walls of the heart
• Smooth (visceral) muscle
•
Found throughout the body in the internal organs
• Skeletal (striated) muscle
–
Attached to bones and produce movement upon command from brain
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Injuries to the Muscle Tissue
• Muscle strain
•
An overstretching or tearing of the muscles and/or adjacent tissues
• Myositis ossificans
•
A condition in which calcium is produced within the muscle after a blow
• Tendonitis
•
Inflammation of the tendon
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The Joints
•
Allow movement according to their range of motion. Three
categories:
1.
Fibrous
–
2.
Immovable joints including bones of the cranium, or skull
Cartilaginous
–
–
Slightly moveable
Includes vertebra in the spine
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The Joints
• Three categories, continued:
3. Synovial
–
–
Freely moveable
Includes the elbow, knee, fingers, etc.
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Injuries to the Joints
• Ligament or capsular sprains
• Dislocations and subluxations
• Synovitis and bursitis
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The Skeletal System
•
•
Provides a framework of support for the soft tissues of the body
and protects the internal organs from damage
There are 206 bones that form the human skeleton and affect our
movement in some way.
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Five Functions of The Skeletal System
1. Provides support for muscles, fat, and soft
tissues
2. Protects internal organs
3. Provides leverage for lifting and movement
through the attachment of muscles
4. Produces blood cells
5. Stores majority of the body’s calcium supply
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Signs and Symptoms of Bone Fracture
• Pain at the site
• Deformity
• Edema (swelling) at
injury site
• Ecchymosis (bruising)
• Grating or crepitus
• Immobility
• Numbness or tingling
• Pale or cold skin due
to impaired
circulation
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Types of Fractures
• Closed (does not break skin)
• Open (bone protrudes through skin)
• Avulsion
• Stress
• Greenstick
• Impacted
• Longitudinal
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Types of Fractures
• Oblique
• Spiral
• Transverse
• Comminuted
• Blowout
• Salter-Harris
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