Class 11: Musculoskeletal AP and Care Ch4 Partial Ch29

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Skeletal System. Life systems and Physiology of the Musculoskeletal System. Elements of the Musculoskeletal System . Gives the body shapeProtects interior organsProvides for movementConsists of more than 600 muscles. Sorts of Muscle (1 of 2). Skeletal (intentional) muscle Attached to the bones of the bodySmooth (automatic) muscleCarries out the programmed solid elements of the body.

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´╗┐Class 11: Musculoskeletal A&P and Care Ch4 (Partial) & Ch29

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Skeletal System

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Anatomy and Physiology of the Musculoskeletal System

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Functions of the Musculoskeletal System Gives the body shape Protects inward organs Provides for development Consists of more than 600 muscles

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Types of Muscle (1 of 2) Skeletal (intentional) muscle Attached to the bones of the body Smooth (automatic) muscle Carries out the programmed strong elements of the body

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Types of Muscle (2 of 2) Cardiac muscle Involuntary muscle Has claim blood supply and electrical framework Can endure interferences of blood supply for just brief periods

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Mechanism of Injury Force might be connected in a few ways: Direct blow Indirect constrain High - vitality harm Twisting power

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Injuries from Falls Frequently after a fall, the compel of the damage is transmitted up the legs to the spine, now and again bringing about a crack of the lumbar spine.

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Fracture Broken bone Dislocation Disruption of a joint Sprain Joint damage with tearing of tendons Strain Stretching or tearing of a muscle Types of Musculoskeletal Injuries

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Closed crack A break that does not tear the skin Open crack External injury related with break Nondisplaced break Simple split of the bone Displaced crack Fracture in which there is real distortion Fractures

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Greenstick Fracture

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Epiphyseal Fracture

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Comminuted Fracture

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Pathologic Fracture

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Deformity Tenderness Guarding Swelling Bruising Signs and Symptoms of a Fracture (1 of 2)

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Crepitus False movement Exposed pieces Pain Locked joint Signs and Symptoms of a Fracture (2 of 2)

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Marked disfigurement Swelling Pain Tenderness on palpation Virtually total loss of joint capacity Numbness or hindered dissemination to the appendage and digit Signs and Symptoms of a Dislocation

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Signs and Symptoms of a Sprain Point delicacy can be inspired over harmed tendons. Swelling and ecchymosis show up at the purpose of damage to the tendons. Torment Instability of the joint is demonstrated by expanded movement.

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Compartment Syndrome Most usually happens in a broke tibia or lower arm of kids Elevated weight inside a fascial compartment Develops inside 6 to 12 hours after damage Pain out of extent with harm Splint influenced appendage, keeping it at the level of the heart. Give quick transport.

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Severity of Injury Critical wounds can be distinguished utilizing musculoskeletal damage reviewing framework.

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Minor Injuries Minor sprains Fractures or disengagements of digits

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Moderate Injuries Open breaks of the digits Nondisplaced long bone cracks Nondisplaced pelvic breaks Major sprains of a noteworthy joint

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Serious Injuries Displaced long bone breaks Multiple hand and foot breaks Open long bone cracks Displaced pelvic cracks Dislocations of real joints Multiple digit removals Laceration of real nerves or veins

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Severe Life-Threatening Injuries (Survival Is Probable) Multiple shut breaks Limb removals Fractures of both long bones on the leg (reciprocal femur cracks)

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Critical Injuries (Survival Is Uncertain) Multiple open break of the appendages Suspected pelvic breaks with hemodynamic shakiness

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You are the Provider You and your EMT-B accomplice are dispatched to the nearby skateboarding arena for a fall damage. The scene is protected. You discover a 18-year-old male who is holding his left arm hidden from everyone else. He gives off an impression of being in a ton of torment. He is cognizant, alarm, and situated with no outer dying.

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You are the supplier proceeded What is the component of damage? What inquiries would it be advisable for you to make a request to decide the patient's conceivable harm? Would it be advisable for you to balance out the patient's c-spine? What might you be able to do to facilitate the patient's agony?

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Scene Size-up Carefully evaluate the MOI. Watch for dangers and dangers to security; avoid potential risk. Consider the requirement for spinal adjustment. Assess the requirement for law authorization. Consider asking for ALS reinforcement.

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Initial Assessment (1 of 2) Ask patient's main dissension; evaluate level of cognizance. Get some information about MOI. Wounds to head may bring about insufficient relaxing. You may regulate oxygen to mitigate nervousness and enhance perfusion. Try not to give the damage a chance to divert you from tending to ABCs.

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Initial Assessment (2 of 2) Treat understanding for stun if indications of hypoperfusion are available. Swathe draining furthest points with sterile dressings to control draining Do not make so tight as to limit distal flow. Screen swathe snugness by evaluating course, sensation, and development distal to damage. Swelling may make wrap turn out to be too tight.

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Transport Decision Provide quick transport if quiet has aviation route or breathing issues. On the off chance that patient had noteworthy MOI, transport quickly regardless of the possibility that patient appears to be alright. Balance out patient on a backboard.

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You are the supplier proceeded with You evaluate ABCs, play it safe, and give oxygen through nonrebreathing cover. Patient is a low-need transport. He discloses to you he fell while on a skateboard. He utilized his correct arm to dampen the fall. Heard a "pop" when he hit the solid. Denies hitting his head or losing awareness. Right lower arm is angulated marginally in the center. He requests that you not touch it.

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You are the supplier proceeded After your underlying evaluation, what would it be a good idea for you to do? Depict the following period of your evaluation.

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Focused History and Physical Exam Use DCAP-BTLS. Injuries, scraped spots, or delicacy might be just indications of a basic damage.

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Rapid Physical Exam for Significant Trauma If you locate no outer indications of damage, request that patient move every appendage precisely, halting instantly if this causes torment. Avoid this progression if the patient reports neck or back torment. Slight development could bring about lasting harm to spinal string.

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Focused Physical Exam for Nonsignificant Trauma Evaluate course, engine work, sensation. On the off chance that at least two furthest points are harmed, transport. Extreme wounds more probable if at least two bones have been broken Recheck neurovascular work previously, then after the fact supporting. Impeded course can prompt to death of the appendage.

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Assessing Neurovascular Status (1 of 4) If anything causes torment, don't proceed with that segment of exam. Beat Palpate the outspread, back tibial, and dorsalis pedis beats.

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Assessing Neurovascular Status (2 of 4) Capillary refill Note and record skin shading. Press the tip of the fingernail to make the skin whiten. On the off chance that ordinary shading does not return inside 2 seconds, you can accept that dissemination is disabled.

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Assessing Neurovascular Status (3 of 4) Sensation Check feeling on the tissue close to the tip of the pointer. In the foot, check the inclination on the substance of the enormous toe and on the sidelong side of the foot.

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Assessing Neurovascular Status (4 of 4) Motor capacity Evaluate solid movement when the harm is close to the patient's hand or foot. Request that the patient open and close his or her clench hand. Request that the patient squirm his or her toes.

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Baseline Vital Signs/SAMPLE History Obtain pattern essential signs as quickly as time permits. Stun is normal. Endeavor to get SAMPLE history without postponing transport. Degree of history relies on upon how rapidly you have to transport.

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Interventions Stabilize ABCs. Control genuine dying. Secure patient to a backboard if basically harmed. Give provoke transport. In the event that patient is not fundamentally harmed, prop on scene. Objective is to settle damage in most agreeable position that takes into account upkeep of good course distal to site.

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You are the supplier proceeded with (1 of 2) You start a centered physical exam. You note delicacy, swelling, and crepitus with tender palpation in the privilege mid-lower arm. Patient can feel you touch his fingers. Distal heartbeat is found. Fine refill is ordinary. Your accomplice physically balances out the harmed limit. You start the SAMPLE history and survey key signs.

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You are the supplier proceeded with (2 of 2) Describe your crisis mind.

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Detailed Physical Exam Inspect and tenderly palpate different furthest points and the spine to recognize fundamental breaks, disengagements, or sprains. Contrast harmed appendage with inverse, uninjured appendage.

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Ongoing Assessment Repeat beginning appraisal and fundamental signs. Reassess mediations. Reassess neurovascular capacity and shade of propped harmed furthest point distal to damage site. Correspondence and documentation Report issues with ABCs, kind of break, and if course was traded off before or in the wake of propping. Report finish depictions of wounds and MOIs.

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Emergency Medical Care Completely cover open injuries. Apply the suitable prop. In the case of swelling is available, apply ice or frosty packs. Set up the patient for transport. Continuously educate doctor's facility staff about injuries that have been dressed and supported.

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Splinting Flexible or unbending gadget used to secure limit Injuries ought to be braced before moving patient, unless the patient is basic. Supporting anticipates promote harm. Ad lib bracing materials when required.

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General Principles of Splinting (1 of 3) Remove garments from the range. Note and record the patient's neurovascular status. Cover all injuries with a dry, sterile dressing. Try not to move the patient before bracing.

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General Principles of Splinting (2 of 3) Immobilize the joints above and underneath the harmed joint. Cushion every single unbending support. Apply col