Basic Tissue Injuries

1. Basic Tissue Injuries Chapter 14

2. 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

3. 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 Introduction

4. 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

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

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

7. 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

8. 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

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

10. 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

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

12. Tissues

13. 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?

14. 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

15. Wounds: open or closed Closed: do not break skin Open: break in skin Require first aid Control bleeding and prevent infection Superficial Injuries to Soft Tissues

16. Abrasions Caused by sliding or skidding on pavement, concrete, dirt, or sand Happen in any sport Different sizes, usually not deep Superficial Injuries to Soft Tissues

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

18. Puncture Wound Pointed object directly pierces soft tissue Most susceptible to infection-tetanus Embedded-MD referral Superficial Injuries to Soft Tissues

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

20. Avulsions Loss of tissue Tissue still attached Flap avulsion Superficial Injuries to Soft Tissues

21. Calluses • the skin becomes thickened due to high friction area or pressure • Shoe doesn’t fit properly

22. Blisters Build-up of fluid that collects under the skin due to friction Superficial Injuries to Soft Tissues

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

24. 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 Superficial Injuries to Soft Tissues

25. Abrasions and Lacerations First aid treatment: Clean, antibiotic ointment, bandage Lacerations: Stitches??-send to MD Treatment

26. Puncture Stabilize object in place: gauze/tape Minor First Aid Incision First Aid Pull edges of wound together-use butterfly strips/steri-strips MD Treatment

27. Avulsions First Aid MD Large flap is torn away-locate it Calluses File off thick skin with pumice stone Treatment

28. Blisters Clean area Donut pad-disperse pressure If it pops--DO NOT PEEL OFF SKIN!! Bites First Aid Do not scratch Allergic-MD Immediately!! Treatment

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

30. 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.

31. 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 Warm-up: Tic-Tac-Know

32. Types of Movement Rotation Adduction Abduction Flexion Extension Dorsiflexion Plantarflexion Types of Movement Supination Pronation Radial deviation Ulnar deviation Inversion Eversion Muscular System

33. 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 Muscular System

34. Muscular System

35. Muscle Strain Overstretching or tearing of the muscles and/or tissues Occurs where tendon meets muscle Hamstrings/ quadriceps Injuries to Muscle Tissues

36. Strain Classifications Complete tear None to mild Decreased to increased Moderate to severe

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

38. Follow up Treatment • Mild • Stretching-maintain ROM • Hold 20-30 seconds/3 sets • 3x day • Moderate • Monitor swelling

39. 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 Injuries to Muscle Tissues

40. 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 Injuries of Muscle Tissues

41. 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)

42. 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

43. Joints/Articulations

44. Muscular System-Review

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

46. 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

47. 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

48. 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

49. Motion Groups for Synovial Joints • Saddle • Two surfaces, one convex and the other concave, it together • Thumb

50. 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