Musculoskeletal Structures and Movement Mechanisms
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Questions and Answers

What is the primary function of ligaments in the musculoskeletal system?

  • Connect muscle to bone
  • Stabilize muscles
  • Protect organs
  • Connect bone to bone (correct)

    • Tendons connect muscles to other muscles.

    False

    What term describes the movement away from the midline of the body?

    Abduction

    A __________ is caused by blunt objects and can vary significantly in severity.

    <p>blunt injury</p> Signup and view all the answers

    Match each type of injury with its definition:

    <p>Abrasions = Skin scraped off due to friction Lacerations = Tear caused by shearing or crushing forces Incisions = Cut made by a sharp object Fractures = Break in bone structure</p> Signup and view all the answers

    What type of injury typically occurs due to repetitive forces on the body?

    <p>Repetitive injury</p> Signup and view all the answers

    Incisions are generally deeper than they are long.

    <p>False</p> Signup and view all the answers

    What are the four stages of the body's response to skin lacerations?

    <p>Homeostasis, Inflammation, Proliferation, Remodelling</p> Signup and view all the answers

    What type of fracture occurs at a 90 degree angle to the bone?

    <p>Transverse</p> Signup and view all the answers

    Contusions are also known as bruises.

    <p>True</p> Signup and view all the answers

    What is an avulsion injury?

    <p>An injury that causes part of the bone to be pulled away with the soft tissue.</p> Signup and view all the answers

    A __________ is a stretched or torn ligament.

    <p>sprain</p> Signup and view all the answers

    Match each type of fracture with its description:

    <p>Greenstick = Common in children, bones are flexible Comminuted = Fracture in three or more places on the same bone Spiral = Caused by torsional force along the bone Fissure = Splinter of bone pulled away from main shaft</p> Signup and view all the answers

    Which of the following is NOT a symptom of strains and sprains?

    <p>Irregularity</p> Signup and view all the answers

    Impact fractures are less likely to cause significant damage compared to other fracture types.

    <p>False</p> Signup and view all the answers

    What does the acronym PILSDUCT stand for in the context of fractures?

    <p>Pain, Irregularity, Loss of movement, Swelling, Deformity, Unnatural movement, Crepitus, Tenderness.</p> Signup and view all the answers

    The 5P's of assessment include Pain, Pulses, Pallor, Paraesthesia, and __________.

    <p>Paralysis</p> Signup and view all the answers

    Which type of injury is considered a distracting injury?

    <p>Head injury</p> Signup and view all the answers

    Amputations typically involve larger parts of the body.

    <p>False</p> Signup and view all the answers

    What is a key step to take if a spinal injury is suspected?

    <p>Start manual inline stabilization (MILS).</p> Signup and view all the answers

    A __________ fracture has no communication to the outside.

    <p>closed (simple)</p> Signup and view all the answers

    Match the following types of fractures with their descriptions:

    <p>Spiral = Fracture caused by twisting or torsional forces Greenstick = Incomplete fracture common in children Oblique = Fracture at an angle Comminuted = Bone broken into three or more fragments</p> Signup and view all the answers

    What is the primary purpose of splinting in fracture management?

    <p>To stabilize and reduce pain</p> Signup and view all the answers

    Rigid collars are still recommended for spinal injury management.

    <p>False</p> Signup and view all the answers

    List the four stages of wound healing.

    <p>Haemostasis, inflammation, proliferation, remodeling</p> Signup and view all the answers

    ___ shock is the most common form in trauma, caused by the reduction in circulating volume.

    <p>Hypovolemic</p> Signup and view all the answers

    Match the type of splint with its use.

    <p>Cardboard = Limb injuries Box splint = Mid shaft femur fractures Traction splint = Pelvic splint Soft collar = Suspected spinal injury</p> Signup and view all the answers

    What should be assessed before and after splinting a fracture?

    <p>Circulation and motor/sensory function</p> Signup and view all the answers

    Elevating a limb can help control external bleeding.

    <p>True</p> Signup and view all the answers

    What is the recommended time limit for using an arterial tourniquet?

    <p>2 hours</p> Signup and view all the answers

    The initial assessment for trauma is known as the ___ survey.

    <p>primary</p> Signup and view all the answers

    Which of the following is NOT a source of bleeding?

    <p>Asthmatic</p> Signup and view all the answers

    Match the type of shock with its description.

    <p>Hypovolemic shock = Caused by loss of blood or fluids Distributive shock = Widespread vasodilation causing relative hypovolaemia Obstructive shock = Mechanical compression of the heart or vessels Neurogenic shock = Related specifically to trauma to the nervous system</p> Signup and view all the answers

    Direct pressure is the first method to control external bleeding.

    <p>True</p> Signup and view all the answers

    What is the main risk associated with prolonged application of a tourniquet?

    <p>Tissue and nerve damage</p> Signup and view all the answers

    ___ is essential before a splinting procedure to ensure no further injury occurs.

    <p>Stabilization</p> Signup and view all the answers

    Study Notes

    Musculoskeletal Structures

    • Bones are connected by various connective tissues: Ligaments (bone to bone), tendons (muscle to bone), and cartilage.
    • Ligaments: Provide stability to joints.
    • Tendons: Enable movement.
    • Skeletal muscle: Contracts and relaxes for movement.
    • Joints: Different types allow for diverse movements.

    Range of Movement Terminology

    • Abduction: Movement away from the midline.
    • Adduction: Movement towards the midline.
    • Eversion: Turning outwards.
    • Inversion: Turning inwards.
    • External rotation: Turning away from the midline.
    • Internal rotation: Turning towards the midline.
    • Pronation: Turning downwards.
    • Supination: Turning upwards.

    Mechanism of Injury

    • Direct: Injury at the site of impact.
    • Indirect: Injury away from the site of impact.
    • Blunt: Impact by a blunt object.
    • Penetrating: Impact by a sharp object.
    • Twisting, shearing: Rotation of the proximal part of a limb causing injury.
    • Repetitive: Repetitive forces on the body can damage hard or soft tissue.

    Injury Types

    • Fractures: Muscular spasms can occur due to pain impulses from broken bone edges. Tonic spasms (muscle tension) attempt to stabilize the area.
    • Skin lacerations: Four stages of healing: homeostasis, inflammation, proliferation, and remodeling.
    • Blood loss: Can occur from direct vessel damage or indirectly from bone marrow damage.

    Types of Wounds - Soft Tissue Injuries

    • Abrasions: Skin scraping, often from falls.
    • Lacerations: Tearing of tissue caused by shearing or crushing forces (blunt trauma). Irregularly shaped.
    • Incisions: Clean cut with sharp edges (e.g., knife, glass).
    • Puncture wounds: Stab wounds with greater depth than length.
    • Contusions: Bruises, changing color during healing.
    • Avulsion: Part of the bone is pulled away with the soft tissue.
    • Amputations: Loss of body parts (e.g., fingers).

    Sprains & Strains

    • Sprains: Stretched or torn ligament. Common in wrists, ankles, and knees. Sporting injuries, slips, trips, and falls are common causes.
    • Strains: Stretched or torn tendon/muscle. Often caused by sports injuries, overuse, or sudden force.
    • Avulsion fractures can occur with both sprains and strains.
    • Symptoms: Pain, deformity, swelling, bruising, and inability to bear weight. Difficult to differentiate in the field.

    Fractures

    • Difficult to classify in out-of-hospital settings.
    • Painful, with potential for secondary injuries to nerves and arteries.
    • Consider pre-existing conditions (e.g., Parkinson's).
    • Analgesics should be administered.
    • Types:
      • Transverse: Break at a 90-degree angle (direct impact).
      • Oblique: Break at an angle.
      • Spiral: Torsional force along the bone.
      • Comminuted: Three or more fractures in the same bone.
      • Avulsion: Tendon or ligament pulls a piece of bone.
      • Impacted: Bone fragments driven into each other.
      • Fissure: Splinter of bone pulled from the main shaft (long bones).
      • Greenstick: Incomplete break, common in children.
      • Open (compound): Communication with the outside environment, risk of contamination.
      • Closed (simple): No communication with the outside.

    Distracting Injuries

    • Injuries that divert attention from other, potentially more significant injuries.

    Assessing Injuries

    • 5 P's of Assessment:
      • Pain: Presence, location, SOCRATES assessment.
      • Pulses: Presence, absence, mark location for re-evaluation.
      • Pallor: Skin perfusion, integrity, capillary refill, critical skin issues.
      • Paraesthesia: Sensory deficits (tingling, numbness).
      • Paralysis: Motor deficits (ability to move the limb).
    • History taking is crucial: Noises heard, weight-bearing ability, range of motion (active, passive, resisted).

    Inspection

    • Deformity: Skin depressions, exposed bone, angulation, associated joint injuries.
    • Swelling, bruising, lacerations, abrasions, punctures, redness, asymmetry.

    Palpation

    • Tenderness, warmth/cold, bony deformity, crepitus, stiffness.

    Key Notes

    • Swelling, deformity, or displacement can compromise nerve and vascular supply.
    • Fractures and bone fragments can sever blood vessels and nerves.
    • Dislocations can trap and compress blood vessels, nerves, and soft tissue.
    • Joint injuries have a high chance of vessel and nerve damage.
    • Manipulating fractures increases the risk of fat emboli.

    Signs & Symptoms of Fractures

    • PILSDUCT:
      • P: Pain
      • I: Irregularity
      • L: Loss of movement
      • S: Swelling
      • D: Deformity
      • U: Unnatural movement
      • C: Crepitus
      • T: Tenderness

    Fracture Complications

    • Potential blood loss within the first two hours (adults):
      • Humerus: Up to 500 ml
      • Tibia: Up to 1000 ml
      • Femur: Up to 2000 ml
      • Pelvis: Over 2000 ml

    Spinal Injuries

    • Start manual inline stabilization (MILS) if a spinal injury is suspected.
    • No suspicion of C-spine:
      • Ask patient to turn head slowly side to side.
      • Palpate for deformity.
      • Ask patient to touch chin to chest and to ceiling. Stop and manage as a spinal injury if pain occurs.

    Management of Musculoskeletal Injuries

    Fracture Management Principles

    • Control bleeding.
    • Restore blood supply.
    • Stabilize sprains.
    • Stabilize the patient.
    • Manage pain. (Splinting helps reduce pain.)
    • Assess circulation, motor, and sensory function before and after splinting.
    • Splint unless there is obvious resistance.

    Types of Splints

    • Carboard: Limb injuries.
    • Box: Limb injuries.
    • Anatomical: Limb injuries.
    • Traction (CT6, CT7, Donway): Mid-shaft femur fractures.
    • Pelvic (Sam splint, T-POD): Suspected pelvic injury.
    • Collar (hard or soft): Suspected spinal injury.

    Rigid Collars

    • Discontinued due to increased risk of pressure areas, pain, impaired jugular venous return, increased intracranial pressure, and impaired respiratory function.

    Soft Collars for Cervical Spinal Immobilization

    • Provides support and reduces motion.

    Haemorrhage Control & Wound Management

    Trauma Assessment

    • Primary Survey: C-A-B-D-E + environment exposure (e.g., hazardous materials).
    • MARCH: Massive Haemorrhage, Airway, Respiration, Circulation, Hypothermia Prevention.

    Types of Shock

    • Shock: Reduced global tissue perfusion leading to organ dysfunction.
    • Hypovolemic shock (haemorrhagic): Most common in trauma, caused by reduced circulating volume.
    • Distributive shock (neurogenic): Widespread vasodilation causing relative hypovolemia.
    • Obstructive shock (cardiogenic): Mechanical compression of the heart or great vessels reducing venous return or ventricular filling.

    General Trauma Management Principles

    • Identify: Identify the haemorrhage.
    • Stop: Stop the haemorrhage.
    • Prevent: Prevent further injury.
    • Maintain: Maintain adequate perfusion.
    • Protect: Protect clotting.

    Sources of Bleeding

    • External bleeding:
      • Capillary: Slow oozing, easily controlled, stops spontaneously.
      • Venous: Steady flow, easier to control, low pressure system.
      • Arterial: Rapid, profuse, spurting with heartbeat, most difficult to control.
    • Internal bleeding: More challenging to recognize.

    Direct vs Indirect Pressure

    • Factors influencing bleeding severity: wound characteristics (size, depth, location, foreign objects).
    • External bleeding control:
      • Elevate the limb: Reduce blood flow.
      • Apply direct pressure: Stop bleeding, promote clotting. Use appropriate dressings.
      • Apply additional bandages: Control persistent bleeding.
      • Indirect pressure: Apply pressure to points that slow blood flow if direct pressure fails.
    • Complicated external bleeding: Indirect pressure.

    Arterial Tourniquets

    • Indications: Catastrophic, life-threatening haemorrhage.
    • Application: Above an arterial bleed to stop blood flow.
    • Complications:
      • Ineffective pressure, venous congestion, rebleeding, tissue and nerve damage, limb loss (increased risk after 3-4 hours, loss after 6+ hours).

    Physiology of Wound Healing

    • Four stages:
      • Haemostasis: Immediate vasoconstriction and clot formation.
      • Inflammation: (0-4 days) Neutrophils and macrophages remove debris and prevent infection.
      • Proliferation: (2-24 days) Connective tissue rebuilds wound, promoting granulation.
      • Remodelling: (24 days - 1 year) Epithelial tissue forms in a moist environment.

    Wound Management

    • Inspect/assess: Site, shape, size, type, other factors (e.g., blood thinners).
    • Dressings: Control bleeding, prevent infection, absorb drainage, protect from injury.
    • Irrigate: Reduce infection risk (e.g., normal saline). Flush cleanest to dirtiest areas.
    • Bandage: Secure dressing, aid in haemorrhage control.
    • Splinting: Provide joint stability.
    • Transport: Emergency room, GP clinic.

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    Description

    Explore the intricate details of musculoskeletal structures, including bones, ligaments, tendons, and joints. This quiz also covers range of movement terminology and mechanisms of injury, helping you understand how our bodies move and react to impact. Test your knowledge on how these elements come together for physical activity.

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