NRS 210 EXAM 1 Questions and Answers

What are soft tissue injuries? Soft tissue injuries, including sprains, strains, dislocations, and subluxations, usually result from trauma. Soft tissue Injury: Sprains Is an injury to the ligaments surrounding a joint, usually caused by a wrenching or twisting motion. Most sprains occur in the ankle, wrist, and knee joints. Classified according to the degree of ligament damage. A first-degree (mild) sprain involves tears in only a few fibers, resulting in mild tenderness and minimal swelling. A second-degree (moderate) sprain is partial disruption of the involved tissue with more swelling and tenderness. A third-degree (severe) sprain is complete tearing of the ligament in association with moderate to severe swelling. A gap in the muscle may be apparent or palpated through the skin if the muscle is torn. Because areas around joints are rich in nerve endings, the injury can be extremely painful. RICE: Rest, Ice, compression, elevation Mild sprains and strains are usually self-limiting, with full function returning within 3 to 6 weeks. X-rays of the affected part may be taken to rule out a fracture. Soft tissue Injury: Strains is an excessive stretching of a muscle, its fascial sheath, or a tendon. Most strains occur in the large muscle groups, including the lower back, calf, and hamstrings. Strains may also be classified as first degree (mild or slightly pulled muscle), second degree (moderate or moderately torn muscle), and third degree (severely torn or ruptured muscle). Clinical manifestations of sprains and strains are similar and include pain, edema, decreased function, and contusion. Pain aggravated by continued use of the joint, tendon, or ligament is common. Edema develops in the injured area because of the local inflammatory response. Mild sprains and strains are usually self-limiting, with full function returning within 3 to 6 weeks. X-rays of the affected part may be taken to rule out a fracture. RICE: Rest, Ice, compression, elevation Cold (cryotherapy) in several forms can be used to produce hypothermia in the involved part. The cold induces physiologic changes in soft tissue, including vasoconstriction and a reduction in the transmission and perception of nerve pain impulses. In addition to pain relief, these changes reduce muscle spasms, inflammation, and edema. Cold is most useful when applied immediately after the injury has occurred. Apply ice no more than 20 to 30 minutes at a time; avoid applying ice directly to the skin. Soft tissue Injury: Dislocation is the complete displacement or separation of the articular surfaces of the joint. It results from severe injury of the ligaments surrounding the joint. MORE SEVERE! Dislocations characteristically result from forces transmitted to the joint that disrupt the soft tissue support structures 1465surrounding it. The joints most frequently dislocated in the upper extremity include the thumb, elbow, and shoulder. In the lower extremity, the hip is vulnerable to dislocation as a result of severe trauma, often associated with motor vehicle crashes (Fig. 62-1). The kneecap (patella) may dislocate because of a sharp, direct blow or after a sudden twisting inward motion while the planted foot is pointed outward.