Basic Tissue Injuries

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Basic Tissue Injuries

• Chapter 14

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Introduction

• Play sports-injuries occur
• Most common-Tissues
• Cuts, abrasions, contusions, muscle strains,
  ligament sprains, inflammation of tendons, joint
  dislocations, fractures, injuries to specific
  organs
• Repetitive motions-overuse injuries
• As an ATC
• Need to recognize different injuries
• Distinguish between levels of injury severity
• Apply appropriate treatment

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Introduction

• Tissue
• A collection of similar cells and their
  intercellular substances that work together to
  perform a particular function
• Anatomy
• The study of structure of the body-how the body
  is put together
• Physiology
• The study of the function of the body-how the
  body works

• Tissues-specialized cells
• Cell the basic unit of life
• Four Categories
• Epithelial tissue
• Connective tissue
• Nerve tissue
• Muscle tissue
• Cells in a particular category of tissue are
  specialized to perform a certain function
• Ex. Muscle-contract

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Introduction

• Cells combine?tissue
• Tissue combine?organ
• Organ (Viscera)
• A structure within the body made up of tissues
  that allow it to perform a particular function
• Lungs, heart, stomach, liver
• Organs combine?system
• Circulatory System, Respiratory System, Nervous
  System

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Cell Anatomy

• Cells-cytoplasm
• Jelly-like material
• Water, carbon, hydrogen, calcium, nitrogen,
  oxygen, phosphorus, food particles, pigment,
  organelles
• 14-4

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Tissues

• Composed of similar cells that are specialized to
  perform a particular function
• Four types
• Epithelial
• Connective
• Nerve
• Muscle

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Tissues

• Epithelial
• Main tissue of skin
• Lines cavities of the body
• Lines principal tubes and passageways that lead
  to the outside
• Protect the internal organs
• Regulates body temperature
• Injuries abrasions, laceration, punctures,
  avulsions
• Infection, inflammation, disease

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Tissues

• Connective
• Supports and connects tissues and parts
• Two types
• Soft Adipose-fatty tissue
• Stores fat-food reserve, insulator, energy source
• Forms fibrous connective tissue that supports
  joints
• Ex. Tendons muscle to bone
• Ligaments bone to bone

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Tissues

• Connective
• Hard
• Bone
• Osseous Tissue-Skeletal system
• Cartilage dense, elastic tissue
• Found in moveable joints
• Ex knee, between discs, nose, ears

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Tissues

• Nerve
• Pathway for communication from the central
  nervous system to the muscles and organs
• Composed of neurons-carry commands and info
  between the brain and rest of the body
• Contusions short-term damage-temporarily
  impairing sensations/movement
• Nerve crushed/severed paralysis-long term

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Tissues

• Muscle
• Tiny muscle fibers that contract movement and
  power
• Three types
• Skeletal-bones/permits movement
• Cardiac-heart to contract
• Smooth/Visceral-in organs

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Tissues
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TOD

• List one place where each of the following can be
  found in the body or an example of each tissue
• Epithelial Tissue
• Connective Tissue
• Muscle Tissue
• What is nerve tissue made up of?

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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 skin, cartilage, muscles, tendons,
  ligaments, veins, or arteries
• Injuries can occur alone or they may accompany a
  fracture or blunt trama

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Superficial Injuries to Soft Tissues

• Wounds open or closed
• Closed do not break skin
• Open break in skin
• Require first aid
• Control bleeding and prevent infection

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Superficial Injuries to Soft Tissues

• Abrasions
• Caused by sliding or skidding on pavement,
  concrete, dirt, or sand
• Happen in any sport
• Different sizes, usually not deep

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• Lacerations
• Caused by tearing motion, resulting in jagged
  edges
• Minor or deep
• Deep
• Nerve, blood vessel, muscle, tendon, ligament

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Superficial Injuries to Soft Tissues

• Puncture Wound
• Pointed object directly pierces soft tissue
• Most susceptible to infection-tetanus
• Embedded-MD referral

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• Incisions
• Caused by knife-like objects
• Clean cuts-very deep
• May involve muscle, tendons, ligaments
• Occur on hard, bony area that are poorly padded

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Superficial Injuries to Soft Tissues

• Avulsions
• Loss of tissue
• Tissue still attached
• Flap avulsion

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• Calluses
• the skin becomes thickened due to high friction
  area or pressure
• Shoe doesnt fit properly

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Superficial Injuries to Soft Tissues

• Blisters
• Build-up of fluid that collects under the skin
  due to friction

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• Bites
• Occur from insects, reptiles, animals and even
  people
• Puncture wounds, lacerations, avulsions

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Superficial Injuries to Soft Tissues

• Contusions
• Bruise received from a sudden blow to the body
• Causes bleeding in the tissue
• ?discoloration
• Severity depends on amount of soft tissue and
  force

• Hematoma
• Closed wound
• Blood-filled swollen area caused by bleeding of
  the tissues
• Blood blister

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Treatment

• Abrasions and Lacerations
• First aid treatment Clean, antibiotic ointment,
  bandage
• Lacerations Stitches??-send to MD

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Treatment

• Puncture
• Stabilize object in place gauze/tape
• Minor
• First Aid

• Incision
• First Aid
• Pull edges of wound together-use butterfly
  strips/steri-strips
• MD

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Treatment

• Avulsions
• First Aid
• MD
• Large flap is torn away-locate it

• Calluses
• File off thick skin with pumice stone

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Treatment

• Blisters
• Clean area
• Donut pad-disperse pressure
• If it pops--DO NOT PEEL OFF SKIN!!

• Bites
• First Aid
• Do not scratch
• Allergic-MD Immediately!!

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Treatment

• Hematoma
• Ice, compression, elevation (ICE)
• MD

• Contusions
• Ice, compression, elevation (ICE)
• Muscle needs to be lengthened
• Ex. Quad-knee flexed
• Donut maybe applied

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TOD

• Make sure your chart is filled out ?
• Scenario
• An athlete who has had a contusion under his
  toenail notices that the nail is pulling away
  from the nail bed. He says the nail is getting
  stuck on his sock. He has heard that pulling the
  nail off will make the new nail grow faster. He
  hands you a pair of pliers and asks you to pull
  it off.
• GET WITH PARTNER 3 AND WRITE DOWN WHAT WOULD YOU
  DO.

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Warm-up Tic-Tac-Know

• Please pick up handouts from the table by the
  door.
• Get with the people in your row.
• Write one word on each index card.
• Abrasions
• Lacerations
• Puncture Wound
• Incisions
• Avulsions
• Calluses
• Blisters
• Hematoma
• Contusions

• Shuffle cards and lay cards down 3 across and 3
  down
• Write a single statement for each group of three
  cards across, down, and diagonally showing the
  relationship between the cards

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Muscular System

• Types of Movement
• Rotation
• Adduction
• Abduction
• Flexion
• Extension
• Dorsiflexion
• Plantarflexion

• Types of Movement
• Supination
• Pronation
• Radial deviation
• Ulnar deviation
• Inversion
• Eversion

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Muscular System

• Origin and Insertion
• Origin movement does not occur
• Insertion movement occurs
• Ex. Quadriceps

• Muscles remain partially contracted at all times
• Muscle tone partial state of contraction
• Muscles are ready for action
• When muscles are not used over a period of
  time-atrophy

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Muscular System
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Injuries to Muscle Tissues

• Muscle Strain
• Overstretching or tearing of the muscles and/or
  tissues
• Occurs where tendon meets muscle
• Hamstrings/
• quadriceps

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Strain Classifications
Complete tear
None to mild
Decreased to increased
Moderate to severe
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Initial Treatment

• Mild and Moderate
• RICE (Rest, Ice, Compression, Elevation)
• Moderate-observe swelling (edema)
• Severe
• RICE
• Immobilize
• May require surgery

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Follow up Treatment

• Mild
• Stretching-maintain ROM
• Hold 20-30 seconds/3 sets
• 3x day
• Moderate
• Monitor swelling

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Injuries to Muscle Tissues

• Myositis Ossificans
• Condition in which bone forms in and replaces
  muscle tissue as a result of trauma
• Calcium is produced
• S/S
• Pain-primary
• Can be palpable
• X-rays-visible 3-4 wks after injury

• Tx
• MD
• Donut pad

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Injuries of Muscle Tissues

• Tendonitis
• Inflammation of a tendon
• Repeated stress resulting in microtearing of the
  tendon sheath
• Swimming, baseball, water polo, football (some
  positions), tennis
• Improper body mechanics/poor conditioning

• S/S
• General soreness
• Point tenderness
• Mild swelling
• Tx
• RICE
• brace

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The Joints

• AKA articulations
• The point at which two or more bones meet
• Allow movement according to their ROM
• Three categories
• Fibrous-Immovable (cranium)
• Cartilaginous-slightly moveable (vertebra)
• Synovial-freely moveable (elbow, knee)

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The Joints/Articulations

• Mobile joints
• Most frequently injured
• Grouped
• Pivot joints- rotation on a single axis
• Hinge joints- flexion/extension
• Joints are surrounded by ligaments, tendons, and
  a protective capsule-filled with synovial fluid
• Synovial Fluid-shock absorber, cushions both ends
  of bone
• Bursa sac full of synovial fluid that reduces
  friction between tendons, bones, ligaments
• Meniscus cartilaginous disc surrounded with
  fluid that also reduces friction during movement
  and adds stability

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Joints/Articulations
44
Muscular System-Review
45
Review

• Movements
• Strains
• 1st
• 2nd
• 3rd
• Joints
• Fibrous, Cartilaginous, Synovial

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Motion Groups for Synovial Joints

• Freely moving
• Ball Socket
• A round end of one bone fits into a cup-like end
  of another bone
• Allowing wide range of movement
• shoulder and hip

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Motion Groups for Synovial Joints

• Pivot
• Projection fits through a ring made up of bone
  and ligament
• 1st and 2nd cervical vertebrae
• Atlas and axis

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Motion Groups for Synovial Joints

• Hinge
• Joint in which the two surfaces are molded
  together closely, allowing a wide range of
  flexion and extension
• Elbow and knee

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Motion Groups for Synovial Joints

• Saddle
• Two surfaces, one convex and the other concave,
  it together
• Thumb

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Motion Groups for Synovial Joints

• Condyloid (Ellipsoid)
• Rounded or oval end of bone fits into a oval
  cavity, allowing all types of movement except
  pivoting
• Wrist joints

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Motion Groups for Synovial Joints

• Gliding
• Two facing bones surfaces meet
• Motion is limited by surrounding tissues and
  ligaments
• Wrist and ankle

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Injuries to the Joints

• Excessive Force
• Three types
• Compression-crushes tissue
• Tension-pulls and stretches
• Sheer-moves against the organization of tissue
  fibers
• Tendons/ligaments are made to withstand tension
  forces, but do not resist sheer or compression
• Excessive can cause ligament or capsular sprains
  or muscle strains

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Injuries to Joints

• Sprain
• Overstretching and/or tearing of ligament or
  tissues caused by a traumatic twisting of a joint
• Vary in degrees of intensity

• S/S
• Deformity
• Crepitation
• A crackling or grating sound heard with movement
• Point tenderness
• Immediate swelling

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Injuries to Joints

• Immediate Tx
• PRICE
• Protect-avoid further injury
• Ex. Sprained ankle-Two person carry
• Rest
• Ice
• Compression
• Elevation

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Injuries to Joints

• Follow-up Tx
• Rehabilitation
• Strengthening Exercises
• Braces
• Taping

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Injuries to Joints

• Dislocations
• An injury resulting from a force that causes a
  joint to go beyond its normal limits
• S/S
• Point tenderness
• Loss of strength
• Complete loss of motion
• Swelling and deformity
• http//www.csmfoundation.org/kneeinjuryweb.mov

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Injuries to Joints

• Subluxation
• Partial dislocation
• felt it slipped out then back in
• S/S
• Dead arm weakness-inability to lift arm
• pain

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Injuries to Joints

• Dislocations/Subluxations
• Immediate Tx
• Check area below injury for pulse and sensation
• Can not find-EMS
• If normal, splint injury
• Ice
• MD

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Injuries to Joints

• Synovitis
• Inflammation of the synovial membrane in a joint
• Repetitive motion/overuse
• S/S
• Pain
• Swelling
• Localized tension
• Increase pain with movement

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Injuries to Joints

• Bursitis
• Inflammation of a bursa
• Located between two bones, muscles, or tendons

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Injuries to Joints

• Immediate Tx
• No swelling-hot pack
• Yes Swelling-ICE technique
• Follow up Tx
• Stretching to promote loss of ROM
• Strengthening exercises
• Prevention
• Proper mechanics

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TOD

• One Sentence Summaries
• A Sprain is a type of _______ that..
• A Hinge joint and a pivot joint are similar in
  that they both___________, but a hinge
  joint______________, while a pivot
  joint________________.
• Bursitis happens because ___________.