Basics of Tissue Basics of Tissue InjuryInjuryCh. 2Ch. 2

Athletic Training for Student Athletic Training for Student AssistantsAssistants

ObjectivesObjectives

Explain the various types of tissue Explain the various types of tissue injuryinjury

Explain tissue Repair and HealingExplain tissue Repair and Healing Explain various bone injuriesExplain various bone injuries Explain bone repair and healingExplain bone repair and healing

Soft Tissue InjuriesSoft Tissue Injuries

ContusionContusion AbrasionAbrasion LacerationLaceration PuncturePuncture IncisionIncision

AmputationAmputation AvulsionAvulsion ContrecoupContrecoup SprainSprain StrainStrain

ContusionContusion

Called BruiseCalled Bruise A closed wound that A closed wound that

bleeds under the skinbleeds under the skin

AbrasionAbrasion

The scraping off of a The scraping off of a layer/s of skinlayer/s of skin

May or may not May or may not bleed depending on bleed depending on how many layers are how many layers are removedremoved

LacerationLaceration

Jagged, irregular Jagged, irregular opening in the skinopening in the skin

Caused by a non Caused by a non cutting object such cutting object such as a wall or poleas a wall or pole

PuncturePuncture

Occurs when a Occurs when a pointed object enters pointed object enters the body through the body through forceforce

Object such as a nail Object such as a nail or tackor tack

IncisionIncision

Open wound made Open wound made by a cutting object by a cutting object such as a scalpel.such as a scalpel.

Rarely seen in Rarely seen in athleticsathletics

AmputationAmputation

An open wound in An open wound in which part of the which part of the body is completely body is completely torn awaytorn away

AvulsionAvulsion

The partial tearing The partial tearing away of a body part.away of a body part.

Can happen when a Can happen when a ring get caught in a ring get caught in a basketball hoop.basketball hoop.

ContrecoupContrecoup

Injury that occurs on the opposite side of Injury that occurs on the opposite side of the initial injurythe initial injury

Usually occurs in the brain as the head Usually occurs in the brain as the head hits against an un yielding surfacehits against an un yielding surface

Example: the posterior part of the skull Example: the posterior part of the skull makes contact with the ground and the makes contact with the ground and the brain hits the anterior part of the skull.brain hits the anterior part of the skull.

Sprains and StrainsSprains and Strains

Sprain – A wound that bleeds internally Sprain – A wound that bleeds internally and that does damage to the Ligamentsand that does damage to the Ligaments

Strain – A wound that bleeds internally Strain – A wound that bleeds internally and that does damage to the Tendons or and that does damage to the Tendons or musclesmuscles

Stages of Soft Tissue Stages of Soft Tissue HealingHealing

Stage I : Acute InflammatoryStage I : Acute InflammatoryStage II: RepairStage II: RepairStage III: RemodelingStage III: Remodeling

Stage I: Acute InflammatoryStage I: Acute Inflammatory

Inflammatory response Inflammatory response phasephase

When a body part is When a body part is injured cells in the area injured cells in the area diedie

There is an increase in There is an increase in blood flow to the areablood flow to the area This brings cells and This brings cells and

chemicals needed for the chemicals needed for the healing processhealing process

Phagocytes: Phagocytes: Specialized cells that Specialized cells that engulf and eat up the engulf and eat up the dead cellsdead cells

Leukocytes: Leukocytes: infection- infection-fighting white blood cellsfighting white blood cells

Platelets: Platelets: Carry blood- Carry blood-clotting materialsclotting materials

Lasts as long as four Lasts as long as four daysdays

Stage II: RepairStage II: Repair

Fibroblastic Repair PhaseFibroblastic Repair Phase The injured area is now filled up with blood, The injured area is now filled up with blood,

cells, and chemicals to help rebuild the area.cells, and chemicals to help rebuild the area. Fibroblasts Fibroblasts begin to build up scar tissue begin to build up scar tissue

around the injured area.around the injured area. This stage lasts six weeks to as long as three This stage lasts six weeks to as long as three

months depending on extent of injurymonths depending on extent of injury

Stage III: RemodelingStage III: Remodeling

Maturation-Remodeling PhaseMaturation-Remodeling Phase This is the body’s way of building tissue This is the body’s way of building tissue

strength in tendons, ligaments, and strength in tendons, ligaments, and muscles to be able to withstand the muscles to be able to withstand the stress that is put on them by activity and stress that is put on them by activity and exercise.exercise.

Can take as long as three years to Can take as long as three years to completecomplete

Injury VideosInjury Videos

http://http://www.csmfoundation.org/Educational_Lowww.csmfoundation.org/Educational_Lower_Extremity.htmlwer_Extremity.html

Bone InjuriesBone Injuries

DislocationsDislocations FracturesFractures

DislocationDislocation

Articulation – where Articulation – where two bone come two bone come together (joint)together (joint)

A Dislocation occurs A Dislocation occurs when a force when a force displaces a bone so displaces a bone so that the ends no that the ends no longer match uplonger match up

FracturesFractures

AvulsionAvulsion StressStress SpiralSpiral LongitudinalLongitudinal CompressionCompression ObliqueOblique ComminutedComminuted

GreenstickGreenstick TransverseTransverse DepressedDepressed BlowoutBlowout PathologicalPathological EpiphysealEpiphyseal

Avulsion FractureAvulsion Fracture

When a tendon or When a tendon or ligament pulls so ligament pulls so hard that it pulls off a hard that it pulls off a piece of the bone.piece of the bone.

Common with Common with sprains, strains, and sprains, strains, and dislocationsdislocations

Stress FracturesStress Fractures

Also know as a Also know as a fatigue fracturefatigue fracture

Occurs as an Occurs as an overuse injury with overuse injury with repetitive stressrepetitive stress

Can not be seen by Can not be seen by an x-ray at firstan x-ray at first

Spiral FracturesSpiral Fractures

A torsional force A torsional force along the length of along the length of the bone causes this the bone causes this type of fracturetype of fracture

Looks similar to a Looks similar to a stripe on a candy stripe on a candy canecane

Longitudinal FractureLongitudinal Fracture

Fracture that runs Fracture that runs the length of the the length of the bonebone

Usually occurs by an Usually occurs by an impactimpact

Compression FractureCompression Fracture

Occurs when Occurs when opposing forces are opposing forces are applied to the bone applied to the bone at the same timeat the same time

Happens often in the Happens often in the spinespine

Oblique FractureOblique Fracture

Diagonal fracture Diagonal fracture across a boneacross a bone

Takes longer to heal Takes longer to heal in a weight bearing in a weight bearing bone due to the fact bone due to the fact that it does not stay that it does not stay in place very wellin place very well

Comminuted FractureComminuted Fracture

Happens when a Happens when a bone is crushed into bone is crushed into smaller piecessmaller pieces

Can happen by blunt Can happen by blunt force traumaforce trauma

Greenstick FractureGreenstick Fracture

When the bone When the bone bends and only bends and only fractures half way fractures half way through it is called a through it is called a greenstick fracturegreenstick fracture

Happens mainly in Happens mainly in adolescentsadolescents

Transverse FractureTransverse Fracture

Travels across the Travels across the bone, perpendicular bone, perpendicular to the boneto the bone

Cause by an impact Cause by an impact that is perpendicular that is perpendicular to the boneto the bone

Depressed FracturesDepressed Fractures

Usually occurs in the Usually occurs in the skull from a direct skull from a direct impactimpact

This impact makes This impact makes an indention in the an indention in the skullskull

Blowout FractureBlowout Fracture

Occurs when an eye Occurs when an eye is pushed hard is pushed hard backwards and down backwards and down into the eye socketinto the eye socket

Small bones under Small bones under the eye are crushed the eye are crushed and embedded into and embedded into the eye musclesthe eye muscles

Pathological FracturePathological Fracture

A disease process like a A disease process like a bone tumor can weaken bone tumor can weaken the bones so that a little the bones so that a little stress will fracture themstress will fracture them

Improper nutrition and Improper nutrition and eating disorders are the eating disorders are the most common cause most common cause among adolescent among adolescent athletesathletes

Epiphyseal FractureEpiphyseal Fracture

Fracture of the Fracture of the epiphseal or growth epiphseal or growth plateplate

Occur mainly in the Occur mainly in the long bones of long bones of adolescent athletesadolescent athletes

Do not occur in Do not occur in adultsadults

Bone HealingBone Healing

Stage I: AcuteStage I: Acute Stage II: RepairStage II: Repair Stage III: RemodelingStage III: Remodeling

Stage I: AcuteStage I: Acute

Bleeding occurs in the areaBleeding occurs in the area Osteoclasts begin to “Eat” the debris or Osteoclasts begin to “Eat” the debris or

reabsorb it to the bodyreabsorb it to the body Osteoblasts begin to add new layers to Osteoblasts begin to add new layers to

the outside of the bone tissuethe outside of the bone tissue Continues for about four daysContinues for about four days

Stage II: RepairStage II: Repair

Osteoclasts and osteoblasts continue to Osteoclasts and osteoblasts continue to regenerate boneregenerate bone

A bony splint (fibrous A bony splint (fibrous calluscallus) forms) forms The fibrous callus is transformed into a The fibrous callus is transformed into a

sleeve of hard callus bonesleeve of hard callus bone The process of turning callus into bone The process of turning callus into bone

starts at about week three and continues starts at about week three and continues for about three monthsfor about three months

Stage III: RemodelingStage III: Remodeling

Takes several years to completeTakes several years to complete Callus is reabsorbed and replaced with a Callus is reabsorbed and replaced with a

fibrous cord of bone that is formed fibrous cord of bone that is formed around the fracture sitearound the fracture site

If a bone never heals it is called a If a bone never heals it is called a nonunion fracturenonunion fracture

Nonunion fractures are common in the Nonunion fractures are common in the scaphoid bone of the wristscaphoid bone of the wrist