Exam 16: Tramatic Injuries
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| Strains: | an injury to a muscle when it is stretched or pulled beyond its capacity.
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| Strains: Clinical Manifestations | Characterized by microscopic muscle tears as a result of overstretching. Common sites include: calf muscles, hamstrings, quadriceps, and lumbosacral region.
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| Strains: Subjective data | 1) Complaint of sudden severe pain that increases with activity.
2) Complaint of soreness, stiffness, and tenderness in affected area.
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| Strains: Objective data | observation of stiffness, ecchymosis, and edema over injury site.
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| Strains: Diagnostic tests | radiographic study is necessary to rule out bone trauma.
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| Strains: nursing management | Ice, heat.
Avoid strenuous activity.
Use firm chair w/ back support.
Avoid high heels.
Use firm mattress w/ pillow under knees.
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| Strains: Medical Management | Leg exercises to prevent thrombosis.
Surgical repair is necessary if muscle is completely ruptured.
Analgesics and muscle relaxants.
Exercises to strengthen lower abdominal muscles may be prescribed if
strain is in lumbosacral region.
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| Contusions: | a soft tissue injury resulting from a blow or blunt trauma.
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| Contusions: Clinical Manifestation | Most common soft tissue injury. Can result in local bleeding under the skin as blood vessels rupture causing bruising (ecchymosis) with a possible hematoma.
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| Contusions: Medical Management | Aimed at alleviating pain, swelling, and bruising.
Apply ice packs or cold compresses for 15 to 20 minutes intermittently for
12 to 36 hours.
Elevate extremity to reduce edema and suppress pain.
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| Sprains: | when a ligament is partially or completely torn
or stretched away from the bone. It causes damage to blood vessels, muscles, and nerves.
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| Sprains: Clinical Manifestations | Result from twisting and hyperextension of a joint, tearing the capsule and ligaments.
Can involve bleeding into a joint (hemarthrosis).
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| Whiplash: | injury to the cervical spine.
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| Whiplash: Clinical Manifestions | Involves hyperextension and resulting compression of anatomical structures.
Usually occurs as a result of sudden acceleration or deceleration (such as car collisions). Symptoms may not be obvious until several days after an injury.
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| Whiplash: Subjective Data | Complaint of pain (most common symptom), which begins in cervical area but may radiate down the arm to the fingers.
Paresthesia (numbness or tingling).
HA
Blurred vision.
Decreased skeletal function.
Weakened hand grip.
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| Whiplash: Objective Data | Edema in cervical spine region with tightening of muscles.
Vital signs usually normal. If hypertension with widened pulse
pressure and bradycardia, then increased intracranial pressure (IICP)
should be suspected and reported.
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| Whiplash: Diagnosis | Physical Examination.
Radiographic studies.
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| Whiplash: Medical Management | Analgesics and muscle relaxants.
Intermittent cervical traction.
Surgery if cervical fracture with displacement occurs.
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| Dislocation: | Occurs when articular surfaces of a joint are no longer intact.
Involves tearing of joint capsule.
Partial or incomplete dislocations are called "subluxations", and involve stretching of joint capsule.
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| Dislocation: Causes | Congenital (e.g., congenital hip displacement).
Result of disease process.
Trauma. May be accompanied by stretching and tearing of ligaments and tendons or fractures.
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| Dislocation: fun facts | Displaced bone may rupture blood vessels.
May or may not be visible.
Dislocation may change length of affected extremity.
Pain and loss of function may be similar to that occurring with fracture.
Common dislocation sites include shoulder, hip, and kne
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| Dislocation: Subjective data | Dislocation of shoulder requires assessment for complaints of
sensation loss and paresthesia.
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| Dislocation: Objective Data | Erythematous.
Discoloration.
Edema.
Pain.
Tenderness.
Limitation of movement.7) Deformity or shortening of extremity.
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| Dislocation: Medical Management | Closed reduction (which corrects deformity through manipulation of the extremity).
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| Carpal Tunnel Syndrome | Disorder of the wrist and hand induced by compression on the median nerve of the wrist.
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| Carpal Tunnel Syndrome: Diagnosis | Electromyogram Reveals weakened muscle response to stimulation
Magnetic resonance imaging. Shows compression and flattening of medial nerve.
Handheld electroneurometer. Predicts motor latency of the median nerve.
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| Herniated Intervertebral Disk. | rupture of the fibrocartilage surrounding an intervertebral disk with resulting pressure on nerve roots.
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| Laminectomy | surgical removal of the bony arches or one or more vertebrae performed to relieve compression of the spinal cord caused by bone displacement from an injury or degeneration of a disk or to remove a displaced vertebral disk.
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| Spinal fusion | removal of the lamina and several herniated nuclei pulposi. A portion of the bone taken from the patient's iliac crest or from a bone bank is used as a bone graft in the vertebral spaces.
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| Discectomy | removal of an extruded disk, often done under microscope.
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| Endoscopic spinal microsurgery | surgery using special scopes that enable the surgeon to successfully remove herniated disks with minimal damage to surrounding tissues.
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| Chemonucleolysis | administration of chymopapain into the nucleus pulposus to destroy the nucleus pulposus. This procedure can be done on patients who have no nerve involvement.
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